Rio Ferdinand Foundation Registration Form (Grove Park Youth Club Summer Programme) Survey

1.Full name:(Required.)

2.Date of birth(Required.)

Date / Time

Date

SuSunday

MoMonday

TuTuesday

WeWednesday

ThThursday

FrFriday

SaSaturday

3.Address: (Required.)

Address

Address 2

City/Town

Postcode

Email Address

Phone Number

4.Name of School/College attended

5.If you are entitled to Free School Meals please provide your HAF Code:

6.Parents / Guardians Contact Name

7.Parents / Guardians Contact Email

9.Equal opportunities:

The Rio Ferdinand Foundation has an Equal Opportunities Policy. This is because we know that some people are discriminated against because of their age, race, sex, disability and / or sexuality. We want to make sure that our organisation is open to everyone and that we do not discriminate, in order to make sure we are operating fairly. We need to know who is and isn’t using the service. For this reason, we would like you to help us by completing the following information.

Please write the ethnic origin that best describes you:(Required.)

10.Do you have any disabilities or additional support needs? If so what support would you need? If no, type N/A(Required.)

11.Do you have any allergies or dietary requirements?(Required.)

12.What is your mobile number?(Required.)

13.What is your email address?(Required.)

14.How did you hear about this opportunity?(Required.)

15.As a Member of the Rio Ferdinand Foundation, you agree to follow the rules set out by staff when engaging in any activities delivered by the Rio Ferdinand Foundation.

The Points outlined in this agreement are in place to protect you and other members of the Rio Ferdinand Foundation, partners, network and wider community.

As a member of the Rio Ferdinand Foundation, I agree to the following terms:

To follow decisions made by staff.
Ensure that I do not instigate or take part in bullying, discriminating or violent behaviour against other members and staff of the Rio Ferdinand Foundation or their partners.
Ensure that I do not attend any Rio Ferdinand Foundation sessions under the influence of illegal substances or alcohol. The Rio Ferdinand Foundation and partners operate a no Smoking Policy in all of its sessions.
Ensure that I show respect to other young people, staff and partners regardless of their background.
Ensure that I do not carry any weapons including knives, guns or any object that could cause harm to myself or anyone at or around any Rio Ferdinand Foundation session.

By signing this registration form, you agree to abide by the rules and policies of the Rio Ferdinand Foundation.
By signing this form, you consent to any media related content taken of you for the use of the Rio Ferdinand Foundation.

Please write / sign your name in the box below;